Provider Demographics
NPI:1457941346
Name:ESSENTIAL QUEST LLC
Entity Type:Organization
Organization Name:ESSENTIAL QUEST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCDC, MAC, SAP
Authorized Official - Phone:254-495-3342
Mailing Address - Street 1:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:MART
Mailing Address - State:TX
Mailing Address - Zip Code:76664-0151
Mailing Address - Country:US
Mailing Address - Phone:254-292-2275
Mailing Address - Fax:
Practice Address - Street 1:401 E TEXAS AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:MART
Practice Address - State:TX
Practice Address - Zip Code:76664-1445
Practice Address - Country:US
Practice Address - Phone:254-495-3342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty